Varicose Veins – and Removal – May Cause Problems

Question 1: I am 82 and have had occasional mild dizzy or "woozy" spells my entire adult life, sometimes infrequently, sometimes daily. One day I actually blacked out, very briefly (I didn't even hit the floor), but it sent me to the doctor.

I got an MRI, EKG and lots of other tests. Everything showed me to be in perfect health. Then a nurse friend told me these spells could all be due to my varicose veins. When I started using elastic stockings, I stopped having spells.

Why do you suppose my doctor didn't think about varicose veins?

Dr. Julie Mitchell Answers:
Very large, bulging varicose veins can cause so much blood to stay in your legs that you don't have enough blood to make it to your head, which can make you dizzy. However, this is rare.

Sometimes doctors get too busy trying to make sure nothing really bad is happening, such as brain cancer, heart disease or an arrhythmia, that we forget about simple causes. But I'm glad you found the answer to your problem with dizzy spells!

Question 2: I am a 43-year-old woman who had vein stripping two weeks ago. Although the surgeon described the operation to me, I honestly was not prepared for the suffering I have endured from the moment I awoke from surgery.

Please urge your readers to seek an alternative treatment for varicose veins.

Dr. Julie Mitchell Answers:
Varicose veins are common, affecting about 40% of women and 20% of men.

Often, varicose veins are small and produce no symptoms, although they may be unattractive. Sometimes varicose veins are larger, achy and cause a mild swelling in the ankles and feet because they are not effective in bringing the blood in your legs back to your heart.

Many women find relief with elastic stockings, but they can be difficult to get on and some are unattractive. However, as you tell us, surgical therapy can be painful, and so I only recommend it when the varicose veins are causing symptoms.

Less painful than vein stripping is sclerotherapy, in which a medication is injected in the veins to clot them off.

Still less painful is laser surgery for small superficial veins; dermatologists at the Medical College of Wisconsin perform this procedure regularly.

Julie L. Mitchell, MD, MS, is an Assistant Professor of Medicine at the Medical College of Wisconsin. She practices internal medicine at the Froedtert & Medical College General Internal Medicine Clinic – East. Her column also appears in the Milwaukee Journal-Sentinel.